Delta Dental Preferred Dental Plan Benefits

Oregon Health Insurance
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Oregon Dental Insurance > ODS Health Plans of Oregon > Preferred PPO Benefits

Delta Dental Preferred PPO Dental Plan Benefits

Plan year maximum, per member

First year benefit maximum

$750

Second year benefit maximum

$1,000

Third year benefit maximum

$1,250

Plan year deductible, per member

$50

Service

Benefit

Preventive

Examinations/x-rays

Prophylaxis

Fissure sealants
Fluoride

PPO
Network

Non-PPO
Network

100%**

80%

Basic - Six Month Waiting Period

Restorative dentistry

Space maintainers

60%

50%

Major - Twelve Month Waiting Period

Oral Surgery

Endodontic

Periodontics

Crowns

Cast restorations

Dentures and bridge work

50%

** Deductible waived only in PPO network

When the member visits:

Preferred Dentists: Benefits are paid at the In Network benefit level. Members are held harmless from balance billing by professionals
Non Preferred ODS Participating Dentists: Benefits are paid at the Out of Network benefit level. Members are held harmless from balance billing by professionals
Non Preferred, Non Participaing Dentists: Benefits are paid at the Out of Network level

Oregon Health Insurance Plans

LifeWise Health Plans of Oregon

Regence BC BS of OR

ODS Health Plans

PacificSource

Providence Health Plans

HealthNet of Oregon

Kaiser Permanente

Oregon Medical Insurance Pool

Medicare Supplement Plans

Medicare Advantage Plans

Other Insurance

Oregon Dental Insurance > ODS Health Plans of Oregon > Preferred PPO Benefits